In pyopericardium, pus accumulates in the pericardial space as a result of infection by pyogenic organisms, most common of which are Staphylococcus aureus and Mycobacterium tuberculosis. These patients are at risk of cardiac tamponade. Causes linked to pyopericardium are pneumonia, empyema, thoracic surgery and haematogenous spread through sepsis. Factors that can predispose to pericarditis include immunosuppression and previous pericardial inflammation and fibrosis. (1).We present a case of pyopericadium in a structurally normal heart which was initially suspected by cardiomegaly in the chest X ray which was taken while working up a male child with fever and cough of 2 weeks duration.
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